Lockhart, Kevin Gregory

Lockhart, Kevin Gregory is an individual health care provider with primary practice located at 5520 Douglas Blvd Suite 110, Granite Bay CA 95746-6288. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lockhart, Kevin Gregory can be contacted via phone (916) 791-5490.

Contact Information

Primary practice address
5520 Douglas Blvd Suite 110 Granite Bay CA 95746-6288
Phone: (916) 791-5490
Fax: (916) 791-3099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 9297T California

Profile Details

NPI number 1962568329
LBN Legal business name Lockhart, Kevin Gregory
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2006
Last updated Apr 23rd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962568329 NPPES
California Other 680428633 TAX ID
California MEDICAID 2230825 TAX ID

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